Extinction of Fear Memories with Glucocorticoids in Veterans with PTSD

糖皮质激素可消除患有 PTSD 的退伍军人的恐惧记忆

• 批准号: 8838095
• 负责人: CAROL S NORTH
• 金额: --
• 依托单位: VA NORTH TEXAS HEALTH CARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-04-01 至 2012-04-01
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8838095
• 关键词: Accidents; Animal Model; Animals; Behavior Therapy; Development; Disease; Double-Blind Method; Event; Extinction (Psychology); Forcible intercourse; Freedom; Fright; Future; General Population; Glucocorticoids; Human; Image; Imagery; Individual; Intervention; Investigation; Longevity; Measures; Medical; Memory; Mental Depression; Methodology; Nightmare; Oral; Outcome Measure; Outcome Study; Participant; Patient Self-Report; Patients; Pharmacotherapy; Physiological; Placebos; Post-Traumatic Stress Disorders; Prevalence; Process; Provider; Randomized Controlled Clinical Trials; Research; Research Design; Risk Estimate; Rodent; Services; Severities; Stimulus; Symptoms; Techniques; Terrorism; Testing; Time; Trauma; Veterans; War; Work; abstracting; base; combat; cost; depressive symptoms; effective therapy; neurochemistry; novel; novel strategies; operation; post intervention; prevent; psychologic; rapid technique; response; social; translational study

Abstract There are very few systematic studies on humans that focus on changing the underlying traumatic memory once PTSD has been established. The proposed project is a translational study based on our work with animal models of PTSD in which coricosterone augmented extinction of contextual fear memories. The study design is a double-blind randomized controlled clinical trial involving eighty-eight OEF/OIF veterans with combat-related PTSD. We plan to pair multiple fear memory reactivations, using a scripted imagery technique, with an oral glucocorticoid or placebo. Participants will be followed at 1, 3, and 6 months post intervention to measure the longevity of the expected effect. Outcome measures will include PTSD symptom severity, depression symptoms severity, and physiological measures. Specific Aims/Hypothesis: Aim 1: Examine the effects of glucocorticoid administration following traumatic memory reactivation on psychiatric symptoms in veterans with combat-related PTSD. Specific hypotheses to be tested: (A) Subjects who receive an exogenous glucocorticoid after traumatic memory reactivation will demonstrate fewer PTSD and depression symptoms one week later, compared to those who receive a placebo after traumatic memory reactivation. (B) The glucocorticoid reduction effects will be cumulative; that is, reduction will persist, and further post- reactivation glucocorticoid administration will further reduce symptoms. (C) Decreases in PTSD and depression symptoms will persist at 1, 3, and 6 months for subjects receiving an exogenous glucocorticoid compared to those subjects receiving placebo. Aim 2: Examine the effects of glucocorticoid administration following traumatic memory reactivation on physiological responses to veteran's personal combat memories. (D) Subjects who receive an exogenous glucocorticoid after traumatic memory reactivation will demonstrate decreased physiological responses one week later, compared to those who receive a placebo after traumatic memory reactivation. (E) As with the psychological measures, suppression of the physiological measures will demonstrate both persistence over time and accumulation with subsequent post-reactivation glucocorticoid administration.

抽象的 很少有针对人类的系统研究专注于改变潜在的创伤记忆 创伤后应激障碍（PTSD）已经成立。拟议的项目是基于我们对动物模型的研究的转化研究 创伤后应激障碍（PTSD），其中皮质酮增强了情境恐惧记忆的消除。研究设计是一个 双盲随机对照临床试验，涉及 88 名患有战斗相关疾病的 OEF/OIF 退伍军人 创伤后应激障碍。我们计划使用脚本想象技术，将多重恐惧记忆重新激活与口头 糖皮质激素或安慰剂。将在干预后 1、3 和 6 个月对参与者进行跟踪，以衡量 预期效果的持久性。结果指标将包括创伤后应激障碍（PTSD）症状严重程度、抑郁症 症状严重程度和生理测量。 具体目标/假设： 目标 1：检查创伤性记忆重新激活后给予糖皮质激素对患者的影响 患有与战斗相关的创伤后应激障碍 (PTSD) 的退伍军人的精神症状。 待检验的具体假设： (A) 在创伤性记忆重新激活后接受外源性糖皮质激素的受试者将表现出 与服用安慰剂的人相比，一周后 PTSD 和抑郁症状更少 创伤记忆重新激活。 (B) 糖皮质激素的减少效果将是累积的；也就是说，减少将持续下去，并且进一步后 重新激活糖皮质激素给药将进一步减轻症状。 (C) 对于接受治疗的受试者，PTSD 和抑郁症状的减少将持续 1、3 和 6 个月。 与接受安慰剂的受试者相比，外源性糖皮质激素。 目标 2：检查创伤性记忆重新激活后给予糖皮质激素对患者的影响 对退伍军人个人战斗记忆的生理反应。 (D) 在创伤性记忆重新激活后接受外源性糖皮质激素的受试者将表现出 与服用安慰剂的人相比，一周后生理反应下降 创伤记忆重新激活。 (E) 与心理测量一样，抑制生理测量将证明： 随着时间的推移而持续存在，并随着随后的重新激活后糖皮质激素给药而积累。